TREATMENTS AND SURGERIES | No-needle, no-scalpel vasectomy


TREATMENTS AND SURGERIES | No-needle, no-scalpel vasectomy

Approximate time30 min

Our urologists are qualified to perform a no-needle, no-scalpel vasectomy, also known as a keyhole vasectomy, at our urology clinics in Greater Montreal and Quebec City.

Usually, the first step for patients seeking a vasectomy is to schedule an initial consultation. During this appointment, the patient fills out a short questionnaire, undergoes a physical examination and is given details about the procedure. Afterward, a second appointment is scheduled for the vasectomy. This takes 2 separate appointments and involves fees for consultation AND surgery.

Alternatively, patients can have both the initial exam and the vasectomy during a single appointment. However, this is only possible if the exam is normal and the patient has no disorder or is taking blood thinners.

For your convenience, we offer both possibilities.

Note that our urologists will have to perform the vasectomy with 2 incisions if the patient is overweight, has a small scrotum, has short vas deferens (sperm duct) or has already had surgery in his genital area (such as a vasovasostomy).

We recommend that another person accompany the patient. When patients have someone with them, they can be offered medication if they begin to feel anxious.

Furthermore, we recommend that the patient avoid drinking coffee or taking any other stimulants on the morning of the vasectomy and that the patient wears tight-fitting underwear for better support.

Please note that the vasectomy procedure is performed in an unaffiliated private clinic and can’t be reimbursed through the Regie de l’assurance maladie du Québec (RAMQ). The confirmation of the patient’s sterility is emailed after receipt of the spermogram results. In rare cases, a second vasectomy should be necessary.


Please note that vasectomies are only performed in a disaffiliated private clinic and, therefore, aren’t covered by the RAMQ. They’re usually carried out in a single appointment. This includes consultation and infertility notification by email after receiving the spermogram’s results.

What happens during a vasectomy?

The vasectomy begins by laying the patient on a table in an operating room designated for minor surgeries. Our urologists then administer a local anesthetic in the skin of the scrotum with a needle-free injector (MADAJET). It takes 5 to 10 minutes for the anesthetic to become effective. After, the area around the genitals is disinfected.

A no-needle, no-scalpel vasectomy involves several steps. First, our urologists will use a clamp to hold the vas deferens in place. Next, they’ll remove the vas so that it can be cauterized and ligated at either end.

Our urologists never use metal clips to clamp the vas deferens. To minimize the risk of recanalization, they’ll isolate the vas deferens on the abdominal side by interposing spermatic fascia. This unique method takes a few minutes of extra work for each duct. It involves covering the vas deferens with a resorbable thread and a layer of tissue that encircles each duct.

Is a vasectomy a permanent method of contraception?

Usually, a vasectomy is not reversible. If the patient changes his mind and wants to have children at some point after his vasectomy, a vasovasostomy can be attempted. However, there’s no guarantee the procedure will be a success.

Are there potential complications to having a vasectomy?

Complications are uncommon, but bleeding, infection, swelling or pain in the scrotum may occur. If inflammation and discomfort persist, an anti-inflammatory medication may be prescribed.

Very rarely, the vas deferens grow back before the spermogram. This is known as early recanalization and occurs when the two ends of the canals reattach and allow the passage of spermatozoa (making the patient fertile).

Delayed spontaneous canalization, occurring after the vasectomy when the vas deferens have been cut, ligated and cauterized, is very rare.

Are there any health reasons why someone shouldn't get a no-needle, no-scalpel vasectomy?

There are a small number of contraindications, all of which are uncommon. These include uncertainty about whether one wants to have children, blood clotting disorders, an inguinal hernia and an undescended testicle. Some patients choose to get a unilateral vasectomy, a procedure in which only one vas deferens is cut.

Does having a vasectomy influence your sex life?

The patient’s sex life won’t be affected. There’ll be no changes in the sensations he feels during sex and no difference in his erection or his ability to ejaculate. Although the ejaculation fluid will no longer contain sperm, the patient won’t notice the difference, as sperm only makes up a small fraction of the fluid. (Most of the ejaculation fluid is produced in the seminal vesicles, two tiny sacs located at the base of the prostrate where the vas deferens open.)

Is the administration of the anesthetic painful?

Vasectomies are usually performed under local anesthesia. This involves injecting a high-pressure liquid anesthetic under the skin. The patient will feel a pinching sensation, like a blow from an elastic band. The anesthetic ensures that there’ll be no feeling in the skin or the underlying tissue.

However, the anesthetic is confined to the area around the injection, and sometimes, an unpleasant sensation can be faintly felt at the upper part of the vas deferens in the abdomen.

There’s a small risk of hematoma since the needle is inserted near veins. The surgery can begin 5 to 10 minutes after administering the anesthetic. Medication is offered to accompanied patients who are anxious about the procedure.

What technique is used for the vasectomy?

After a physical exam, our urologists determine whether the patient can be operated on using the no-needle, no-scalpel vasectomy method. This technique involves making a single incision at the centre of the scrotum. In part, the decision will depend on the length and mobility of the vas deferens.

Men who are overweight, have had scrotal surgery or have been referred to the clinic following a failed vasectomy may require a vasectomy technique that involves two incisions (one on either side). This technique may also be necessary if the vas deferens are too short for a standard central incision. In such cases, the cost of the vasectomy is higher.

Can a spouse be present during the vasectomy?

Typically, yes, but not during the active COVID-19 period. Thank you for your understanding!

The person accompanying the patient to the procedure can be present in the operating room during the vasectomy if it helps to calm the patient. Note that a protective screen is placed over the patient’s chest to prevent him from seeing the surgery.

Contact us to schedule a no-needle, no-scalpel vasectomy in Montreal, Laval, on the South Shore or in Quebec City.

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Preparation for a vasectomy

The day before the operation
Shave the scrotum. Shaving is usually performed dry without water or soap and with a razor blade or straight razor by applying traction over the skin. This way, there is less chance of injury to the scrotum than when shaving with water or with an electric razor. Don’t use hair removal cream.
The morning of the operation
We recommend that the patient be accompanied by someone else; it’s also recommended that the patient avoid coffee or other stimulants the morning of the vasectomy.

Patients who are exceptionally nervous or who experience vasovagal shock can take 1 Gravol 50 mg 1 hour before surgery.

Post Vasectomy spermogram – Recommendations after a vasectomy

The first day
We recommend taking Tylenol every 4 hours for the first day. Avoid Advil brand or other anti-inflammatory medications that can increase the risk of swelling.
After 24 hours
A shower is permitted after 24 hours.
After 48 hours
Our urologists recommend that you treat the affected region over the first 48 hours with ice or a bag of frozen peas at 15-minute intervals. This reduces post-operative swelling and discomfort.
The week after the operation
Avoid any physical exertion, sexual activity or sports during the first week. Afterwards, you’ll be able to resume normal physical and sexual activities. You must continue using contraception until sterility is confirmed.

Most men having undergone a vasectomy will be sterile at the first spermogram (that is, “sperm test”). Sometimes, more than 1 test is required to reach sterility. After a week, it’s also recommended to begin to be more sexually active and to continue for the next 3 months. Ideally, a total of 20 to 40 ejaculations helps improve the chances of being sterile.
After 3 to 4 months
The spermogram analysis is done 3 or 4 months after the vasectomy. Sampling must be performed at home by masturbating into a sterile container (available in our clinics or pharmacies/CLSC). This container must directly collect all sperm emitted from ejaculation. A 3-day abstinence period must be respected before the sample is collected. The specimen must be complete. Even the loss of only a few drops must be reported.

Ideally, the time between sample collection and the arrival to the laboratory should not exceed 1 hour. You must keep the sample at body temperature in your shirt or pants pocket.

You can also go to a hospital of your choice or a private laboratory.

You’ll receive written confirmation by e-mail about your results and what activities to do, if necessary. You can also call the secretary to confirm your sterility. This may take from 2 to 4 weeks if the semen analysis is performed in a hospital setting since it’s constructed in microscopy.

For patients who wish to do it in a private laboratory, we offer the NASCI test in collaboration with laboratory Biron. The sample can be left in any Biron lab by appointment. It’s the only post-vasectomy semen analysis performed by flow cytometry. It’s more reliable and less subjective to detect the presence of sperm. There’s less likelihood of repeating a second sperm test 3 months later. It’s less restrictive for patients. The result is also fast, about 1 week.
What should I do if I still have not received my results?
You should receive a written confirmation of your results with the appropriate course of action. If after 2 weeks you have not had any news, call the secretary to confirm your test results.
What should I do if the result is uncertain?
If the results are inconclusive, you must undergo a second spermogram in another 3 months.
What should I do if there is a complication and your office is closed?
If any complication or problem occurs outside our business hours, or you cannot contact the secretary or a nurse, please go to Verdun Hospital Emergency. The emergency physician will try reaching out to our urologists for a report. Our urologists will then be able to give their recommendations over the telephone.

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Would you like to make an appointment, or do you have any questions? Write to us and we will get back to you as soon as possible!

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